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Parenting for Lifelong Health Ages 2-9: Reducing the Risk of Child Maltreatment in Low- and Middle-Income Countries Through the Development, Evaluation, and Dissemination of Evidence-Based Parenting Programmes

In high-income countries, parenting programmes have been shown to be effective in reducing the risk of child maltreatment. However, there is limited evidence on their effectiveness in low- and middle-income countries (LMICs). In collaboration with the World Health Organisation and UNICEF, we have initiated a partnership called Parenting for Lifelong Health (PLH) to develop and test a suite of parenting suitable for LMICs.  This poster presentation focuses on the PLH for families with children ages 2-9  – the Sinovuyo Caring Families Programme.

The Sinovuyo Caring Families Programme’s development and evaluation is being implemented over 4 phases in South Africa: 1) Development Phase: community based participatory research in 2012 to adapt evidence-based parenting principles to a local cultural context; 2) Pilot Phase: a pilot randomised controlled trial in 2013 to test programme feasibility and initial effects (n=68); 3) Efficacy Phase: a larger randomised controlled trial in 2014-2016 to evaluate programme efficacy and test potential moderators and mediators of intervention effects (n=250); and 4) Dissemination Phase: further testing in other low- or middle-income countries to establish effectiveness and plan for wide-scale rollout by 2020.

Formative research found a high receptivity to evidence-based parenting principles that have been shown to improve parenting and reduce child behavior problems. The pilot feasibility trial showed improvements in parent self-report of positive parenting for the intervention group in comparison with the control group (F=8.93, p=.004, Cohen's d=0.74). The programme was also implemented with an acceptable degree of dosage (64.4% attended 9 or more sessions), participant satisfaction, cultural acceptability, and programme fidelity.

This study is the first in sub-Saharan Africa to use a systematic approach to programme development and evaluation that includes a randomised design of an evidence-informed parenting programme to reduce violence against young children. Initial results indicate that the programme is feasible, culturally acceptable, and has the potential to reduce the risk of child maltreatment by improving positive parenting behaviour. Further testing is necessary and currently underway to determine programme efficacy prior to dissemination throughout low- and middle-income countries.